Prostatitis

Question 1

what is prostatitis

Answer 1

inflammation of the prostate gland. It is the most common urological problem in men under 50 years old

Question 2

What is prostatitis comprised of

Answer 2

acute bacterial prostatitis, chronic bacterial prostatitis, nonbacterial prostatitis, and prostatodynia

Question 3

What is the pathophysiology of prostatitis

Answer 3

Ascending urethral infection - occasionally can be through direct/lymphatic spread however

Question 4

What are the causative organisms of prostatitis

Answer 4

E- Coli (most common), Enterobacter, Serratia, Pseudomonas, and Proteus species. Sexually transmitted infections, such as Chlamydia or Gonorrhoea, are a rare cause.

Question 5

what are the risk factors of prostatitis

Answer 5

For bacterial: 
Indwelling catheters
Phimosis or urethral stricture
Recent surgery, including cystoscopy or transrectal prostate biopsy
Immunocompromised

Chronic prostatitis:
Intraprostatic ductal reflux
Neuroendocrine dysfunction
Dysfunctional bladder

Question 6

what are the clinical features of bacterial prostatitis

Answer 6

LUTS

Perineal pain

Pyrexia

Suprapubic pain

Inguinal lymphadenopathy

Question 7

What are the clinical features of chronic prostatitis

Answer 7

pelvic pain or discomfort for at least 3 months (Prostatodynia), alongside LUTS; the perineum is the most common site for pain

Question 8

How do you investigate prostatitis

Answer 8

Urine cultures

Abx Therapy guided from above

Others to consider

• STI screens
• routine bloods

Question 9

What is the management of bacterial prostatitis

Answer 9

First line
Prolonged Abx treatment - quinolone
Analgesia

Second line
Alpha blockers / 5a reductase inhibitors
( can be used for chronic prostatitis too )